Bill and Melinda Gates have paid for 15,000 medicinal molecules to be shipped to a leading laboratory in Belgium to be tested as a potential cure to the coronavirus.
The therapeutic samples, all active ingredients in current antiviral treatments, will be screened at high speed for their inhibiting effect on particles developed from a swab from the first Belgian patient to be diagnosed.
The molecules, from the Scripps research institute in California, will be shipped to the Rega Institute for Medical Research, in Leuven, 20 miles (32km) east of Brussels. The Scripps institute has an extensive collection of the active ingredients of existing or in-development drugs.
What is Covid-19 - the illness that started in Wuhan?
It is caused by a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. Many of those initially infected either worked or frequently shopped in the Huanan seafood wholesale market in the centre of the Chinese city.
Have there been other coronaviruses?
Severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals. In 2002, Sars spread virtually unchecked to 37 countries, causing global panic, infecting more than 8,000 people and killing more than 750. Mers appears to be less easily passed from human to human, but has greater lethality, killing 35% of about 2,500 people who have been infected.
What are the symptoms caused by the new coronavirus?
The virus can cause pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. Recovery depends on the strength of the immune system. Many of those who have died were already in poor health.
Should I go to the doctor if I have a cough?
UK Chief Medical Officers are advising anyone who has travelled to the UK from mainland China, Thailand, Japan, Republic of Korea, Hong Kong, Taiwan, Singapore, Malaysia or Macau in the last 14 days and who is experiencing a cough or fever or shortness of breath to stay indoors and call NHS 111, even if symptoms are mild.
Is the virus being transmitted from one person to another?
China’s national health commission has confirmed human-to-human transmission, and there have been such transmissions elsewhere.
How many people have been affected?
As of 6 March, the global death toll was 3,404, while more than 100,000 people have been infected in more than 80 countries, according to the Johns Hopkins University Center for Systems Science and Engineering.
Why is this worse than normal influenza, and how worried are the experts?
We don’t yet know how dangerous the new coronavirus is, and we won’t know until more data comes in. The mortality rate is around 2% at the centre of the outbreak, Hubei province, and less than that elsewhere. For comparison, seasonal flu typically has a mortality rate below 1% and is thought to cause about 400,000 deaths each year globally. Sars had a death rate of more than 10%.
Another key unknown is how contagious the coronavirus is. A crucial difference is that unlike flu, there is no vaccine for the new coronavirus, which means it is more difficult for vulnerable members of the population – elderly people or those with existing respiratory or immune problems – to protect themselves. Hand-washing and avoiding other people if you feel unwell are important. One sensible step is to get the flu vaccine, which will reduce the burden on health services if the outbreak turns into a wider epidemic.
Is the outbreak a pandemic?
A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed outside China, but by no means in all 195 countries on the WHO’s list. It is also not spreading within those countries at the moment, except in a very few cases. By far the majority of cases are travellers who picked up the virus in China.
Should we panic?
No. The spread of the virus outside China is worrying but not an unexpected development. The WHO has declared the outbreak to be a public health emergency of international concern. The key issues are how transmissible this new coronavirus is between people, and what proportion become severely ill and end up in hospital. Often viruses that spread easily tend to have a milder impact. Generally, the coronavirus appears to be hitting older people hardest, with few cases in children.
Prof Johan Neyts, who will carry out the analysis in Leuven, said he expected results within a fortnight of the shipment arriving in Belgium.
He said: “The Bill & Melinda Gates Foundation hopes that there are one or more molecules among the 15,000 substances that can also inhibit the new coronavirus. We’ll figure that out for them. We will know the results a week or two after the shipment is delivered.”
The biosafety laboratory in Leuven is one of the few facilities in the world able to test thousands of molecules at high speed.
The cost to the Bill & Melinda Gates Foundation will be “a few tens of thousands of euros”, Neyts said. “That’s nothing compared to what it costs to design and market a medicine from scratch,”, he told De Standaard newspaper.
Neyts said he did not expect a miracle cure but that any sign of inhibition of the Covid-19 disease would be considered a significant breakthrough.
He said: “A bit is also good. Or even better: a few substances that inhibit a little, and which we can then combine to hopefully cure seriously-ill patients.”
The Bill & Melinda Gates Foundation has said it will provide up to $100m to improve detection, isolation and treatment efforts in response to the global epidemic. By Wednesday morning, more than 93,000 people had been infected in more than 80 countries and the global death toll was 3,190.
Writing on the website’s foundation Gates, a co-founder of Microsoft and one of the world’s wealthiest private individuals, said he believed there were promising efforts being made to find vaccines “ready for larger-scale trials as early as June”.
He added: “Drug discovery can also be accelerated by drawing on libraries of compounds that have already been tested for safety and by applying new screening techniques, including machine learning, to identify antivirals that could be ready for large-scale clinical trials within weeks.”
There are no proven treatments for coronavirus but a few drugs are already being tested on humans in China. One, Kaletra, has previously been used to treat people with HIV. It has been tested on 200 people so far and results are expected in about a week.
A second, Remdesivir, was tested during the Ebola outbreak in the Democratic Republic of the Congo in 2018 but it was found to be insufficiently effective.
Both trials were expedited by the World Health Organization. As they have been approved for other conditions there will not need to be the usual safety tests on animals and humans.
